Second Opinion Network

ABSTRACT

Systems and methods are provided to facilitate consultations between a referral source (e.g., labs, pathologists and patients) and a consultant (e.g., pathologist, radiologist, or other digital image analyst). Links between the various referral sources and consultants are established through a scanning center via a data communication network such as the Internet. The referral source sends a slide to the scanning center where the corresponding digital slide is posted for review and analysis by the consultant. Upon completion of the analysis and report, a digital slide conference is conducted through the scanning center that provides a venue for direct communication regarding the consultation. The scanning center may also facilitate payment from the referral source to the consultant.

RELATED APPLICATION

The present application claims priority to U.S. provisional patentapplication Ser. No. 60/914,571 filed Apr. 27, 2007, which isincorporated herein by reference in its entirety.

BACKGROUND

1. Field of the Invention

The present invention generally relates to medical diagnosis and morespecifically relates to providing a network of pathologists that rendersecond opinions on medical diagnoses.

2. Related Art

In the current state of medical diagnoses, pathologists may feeluncomfortable rendering a final diagnosis on a difficult case and/or acase outside his or her area of expertise. Such a pathologist may want asecond opinion and not be able to get one from within the pathologist'spractice group or medical organization. Alternatively, a patient maysimply ask for a second opinion.

In these situations, a pathologist typically sends one or more of thepatient's glass slides (with a specimen on it) to a consultingpathologist, typically someone with whom the pathologists or thepathologist's lab has a standing relationship, to receive the secondopinion. The turnaround time for a second opinion can be extremely slow,weeks even months for the result (e.g., the more famous/expert theconsulting pathologist, the longer the wait), particularly in caseswhere the consulting pathologist lives in another country and slides areheld up in customs. Eventually, the provider of the second opinion sendsback a report (or perhaps delivers the report orally via telephone) andhopefully also sends back the glass slide. A common problem today isthat original slides never get returned.

The consulting pathologist who renders the second opinion may bill thereferring pathologist for the consultation or may submit billing to aninsurance carrier directly. The carrier may reimburse if they considerthe second opinion medically necessary. Carriers also may choose not toreimburse the pathologist who renders the second opinion, whichdiscourages willingness to provide second opinions.

Additionally, a patient may want a second opinion but not feelcomfortable requesting one, or a patient may request a second opinionand be denied. For example, the patient's primary care physician mayconclude that a second opinion is not necessary or the insurance carriermay deny the requested second opinion. In any case, when a patient isdenied a requested second opinion the patient has few options.

Therefore, what is needed is a system and method that overcomes thesesignificant problems found in the conventional systems as describedabove.

SUMMARY

Described herein are systems and methods that establish a network ofknown pathologists who provide consultations to labs, pathologists andpatients, using digital pathology. Advantageously, the systems andmethods described herein provide an infrastructure that facilitatesformal and information second opinions, provides subject matterexpertise that is not available to a particular practice group ormedical organization, allows for workload balancing, skill-building,education, and satisfaction of patient requests. An additional advantageis that highly regarded experts who are recognized as the leadingpractitioners in their respective fields are made accessible to smallpractice groups and individuals that would otherwise not be able toconsult with such an expert.

In one embodiment, the system includes a network of participatingconsultants and referral sources. For example, consultants may includeindividuals, medical groups and educational facilities, just to name afew. Referral sources may include doctors, pathologists, labs, medicalgroups, hospitals, educational facilities, and individual patients aswell as other referral sources. The participating referral sources areprovided with mailers for glass slides or alternatively the referralsources are provided with digital slide scanners or access to digitalslide scanners.

The physical slide is sent from the referral source (e.g., doctor, lab,patient) to a scanning center for creation of a digital slide and thenthe physical slide is returned to the referral source. Alternatively, ifthe referral source has a digital slide scanner or has access to adigital slide scanner (e.g., at a community health facility or thelike), the digital slide is electronically sent to the scanning center.The scanning center then makes the digital slide available for viewingby a consulting pathologist via a communication network such as theInternet.

Advantageously, the consulting pathologist can view and analyze thedigital slide at his or her convenience and make a diagnosis.Subsequently, a digital slide conference (e.g., an audio-videoconference) is hosted by the scanning center to facilitate informationexchange between the consulting pathologist and referral source (doctor,pathologist, patient, or any combination).

Significant benefits are realized from the described systems and methodsfor a second opinion network. Some of the benefits include real-timediscussions between the expert pathologist(s) and the referral sourcevia digital slide conferencing; establishing turn around time (“TAT”)requirements for participation; original glass slides are not lost (ornever returned); and simplified economics for consultants (e.g., patientpays directly for requested second opinion). Other features andadvantages of the present invention will become more readily apparent tothose of ordinary skill in the art after reviewing the followingdetailed description and accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

The details of the present invention, both as to its structure andoperation, may be gleaned in part by study of the accompanying drawings,in which like reference numerals refer to like parts, and in which:

FIG. 1 is a network diagram illustrating an example system for a secondopinion network according to an embodiment of the invention;

FIG. 2 is a flow diagram illustrating an example process forimplementing a second opinion network according to an embodiment of theinvention;

FIG. 3 is a flow diagram illustrating an example process forfacilitating a second opinion analysis according to an embodiment of theinvention;

FIG. 4 is a flow diagram illustrating an example process forfacilitating a digital slide conference according to an embodiment ofthe invention; and

FIG. 5 is a block diagram illustrating an example computer system thatmay be used in connection with various embodiments described herein.

DETAILED DESCRIPTION

Certain embodiments as disclosed herein provide for a second opinionnetwork that links referral sources (e.g., referring pathologists,patients) and consulting pathologists to facilitate second opinionsregarding analysis of digitized microscope slide specimens. For example,one method as disclosed herein allows for a referral source to scan amicroscope slide into a digital format and then send the digital slideto a scanning center where it is hosted and made available to one ormore consultants via a data communication network. After an analysis hasbeen completed by the one or more consultants, a digital slideconference between the referral source and the one or more consultantsis hosted by the scanning center via the data communication network. Thescanning center may also facilitate payment to the consultant.

After reading this description it will become apparent to one skilled inthe art how to implement the invention in various alternativeembodiments and alternative applications. However, although variousembodiments of the present invention will be described herein, it isunderstood that these embodiments are presented by way of example only,and not limitation. As such, this detailed description of variousalternative embodiments should not be construed to limit the scope orbreadth of the present invention as set forth in the appended claims.

FIG. 1 is a network diagram illustrating an example system 10 for asecond opinion network according to an embodiment of the invention. Inthe illustrated embodiment, the referral source 20, scanning center 30,and consultant 40 each have respective data storage areas 25, 35, and 45and are all connected via a communication network 50. The referralsource 20 originates the referral for a second opinion. This may be atthe direction of a lab, the attending physician, or at the request ofthe patient. The referral source 20 can send the glass slide to ascanning center 30 via a physical delivery and return infrastructure 55or it can scan the slide itself and then send a digital slide to thescanning center 30 via the network 50. In one embodiment, the referralsource 20 can send metadata information regarding the digital slide tothe scanning center 30 and store the native digital slide image data inits local data storage 25. At some subsequent time (e.g., during offpeak network usage hours) the referral source can send the nativedigital slide image (which may be several gigabytes in size) to thescanning center 30.

The scanning center 30 scans the physical slide and returns it to thereferral source 20 (if it receives the original physical slide). Thisadvantageously eliminates the problem of lost or never returned slidesthat is common today. Whether receiving a physical slide or a digitalslide from the referral source 20, once the scanning center 30 has thedigital slide, it stores the digital slide and its respective metadatainformation and makes it available for viewing by the consultant 40 viathe network 50. The scanning center 30 may also notify the consultant 40that the digital slide is available for viewing. Such notice can beaccomplished by electronic communication (e.g., email, text message,chat message, or the like) or by more traditional means including phone,fax, and regular mail.

In one embodiment the scanning center 30 initially receives metadata fora digital slide and uses the metadata, which includes a reference to thelocation of the digital slide image stored in data storage 25 at thereferral source device 20, to facilitate the rendering of the secondopinion. In such an embodiment, the scanning center 30 may subsequentlyreceive the digital slide image for storage in the data storage area 35in association with the related metadata. Storage at the scanning centeris advantageous because the scanning center is configured for dataredundancy and backup. The scanning center 30 is also configured forhigh bandwidth data communications so it can facilitate rapid viewing ofthe large amounts of data typically associated with high image qualitydigital slides. For example, during a digital slide conference thescanning center 30 may provide multiple gigabytes of data simultaneouslyto several remote viewers (e.g., referral source devices and consultantdevices).

The scanning center data storage area 35 is preferably configured tomanage and store digital slide metadata and digital slide image data forall of the digital slides in the second opinion network. For digitalslides that have the image data stored elsewhere (e.g., in local storageat the referral source device) the data storage area 35 includes areference to the native digital slide image data (e.g., a link or otherelectronic address). In this fashion the scanning center 30 operates asa central database 35 of all of the digital slides and relatedinformation (metadata) in the network.

The consultant 40 views the digital slide via the network 50, conductsan examination of the digital slide, renders a diagnosis and thendelivers a report to the referral source 20. The report can be deliveredin the context of a digital slide conference that allows the consultant40 to walk through the analysis while both the consultant 40 and thereferral source 20 are simultaneously viewing the digital slide hostedby the scanning center 30 via the network 50. In one embodiment, thedigital slide conference may include the patient. The digital slideconference can be recorded and made part of the patient's medical file.Alternatively, a written report or other report can be delivered to thereferral source.

In one embodiment, the scanning center 30 also includes decision supporttools that can be used by a consultant when analyzing a digital slideimage. Such tools may assist the consultant with making a diagnosis ormay provide specific digital slide image related information such ascell count or other information that may be the result of clinicalalgorithms processed against the digital slide image data.

The scanning center 30 may also store a profile for each consultant thatallows the consultant to maintain personal and professional informationthat can be reviewed by potential referral sources when making adecision of which consultant to engage for slide analysis (whethersecond opinion or original analysis). In one embodiment, a profile mayinclude references to prior work performed by the consultant with linksto digital slides previously analyzed. Additional collections ofinformation may also be provided by the consultant and stored in datastorage area 35.

The second opinion system establishes a network of pathologists whoprovide second opinions for doctors or labs who want them and also forpatients who request them. Participating pathologists may participatebecause they want to handle secondary consults for financial or clinicalinterests. Advantageously, patients who want a second opinion can payfor their consultation and feel confident that they were tapping into anexpert network and the second opinion was unbiased by the interests ofan insurance carrier. Similarly, labs who want a second opinion alsofeel confident because they are tapping into an expert network.

One particular advantage of using digital pathology for the secondopinion network is that it facilitates a quicker second opinion (e.g.,by establishing turn around time (“TAT”) requirements forparticipation). Additionally, the use of digital pathology also enablesreal-time discussion between the referral source 20 and the consultant40 (e.g., an expert pathologist) via digital slide conferencing. Thisreal-time discussion has the added benefit of facilitating the transferof knowledge from the experts to other medical practitioners.

Another significant advantage of the second opinion network system isthat it provides easy access for labs and patients to leadingpathologists in a variety of fields. These leading pathologist areenabled through the second opinion network to efficiently and costeffectively provide second opinions outside of existing medical practicegroups to improve the quality of diagnostic results, further educatemembers of the practice group, and reduce the economic influence andimpact of medical insurance carriers. For example, participatingpathologists are provided with an additional source of revenue and arealso allowed greater access to clinically-interesting cases which mayfurther an individual pathologist's notoriety and recognition as anexpert in a particular field. Additionally, just being selected as areviewing expert on high profile cases or very difficult cases canprovide a certain amount of prestige to the expert.

As mentioned above, the initial step in the second opinion process isfor the physical slide to get scanned to create a digital slide. Thescanning can take place at the referral source 20 (e.g., lab, doctoroffice, hospital, etc.), at a third party scanning center 30, or even atthe consultant 40. In one embodiment, a third party scanning center 30may provide referral sources 30 with postage paid mailer envelopes inwhich physical slides can be sent to the scanning center 30 or to theconsultant 40. For example, experts who provide a large volume of secondopinions or who operate their own lab may prefer to have their owndigital scanner.

The scanning device can be any of a variety of digital scanners,including conventional image tiling devices or the faster and higherquality linear array based devices such as the patented ScanScope®device produced by Aperio Technologies, Inc. described in U.S. Pat. No.6,711,283 which is incorporated herein by reference in its entirety.

Once the digital slide is available for viewing at the scanning center30 (when the physical or digital slide is not sent directly to theconsultant), the scanning center 30 notifies the consultant 40 that theslide is ready to be analyzed. In one embodiment, the scanning center 30may facilitate the selection of the expert consultant 40, for example ifthe referral source 20 has not identified or pre-arranged who theconsultant 40 is to be. If the consultant 40 has been selected by thereferral source 20 (e.g., patient or referring physician/pathologist)the scanning center 30 notifies the identified consultant 40. Theconsultant 40 then accesses the scanning center 30 via the network 50 toreview the digital slide within an agreed-upon time frame.

In one embodiment, certain security measures may be in place at thescanning center that may, for example require the consultant 40 toprovide a user name and password in order to gain access to the digitalslide to be reviewed. The consultant 40 may have an account with thescanning center 30 such that a series of digital slides may be presentedto the consultant 40 upon logging in to the scanning center 30. Thescanning center may also include certain administrative softwareutilities to allow the expert to make notes (hand written and scanned,voice recordings, or other) that are stored in a data storage area 35 atthe scanning center 30 in association with the related digital slide.The administrative utilities may also provide the referral source 20with the ability to provide a context for the digital slide, withbackground, demographic or other information that may be helpful to theconsultant 40 when reviewing the digital slide. In one embodiment, thepatient's entire medical file may accompany the digital slide that isprovided to the consultant 40.

In one embodiment, the scanning center is a special site that supporthigh bandwidth communications, so as to facilitate simultaneous access,including digital slides conferences, to multiple digital slides bymultiple consultants, without degradation in viewing performance.

In one embodiment, the referral source 20 scan the physical (glass)slide and the resulting digital slide is stored at the referral source20, where it is accessed via the data communication network 50 by theconsultant 40. In this case, the digital slide is not transported to thescanning center 30, although (meta) data about the digital slide may betransported to the scanning center for incorporation into the databaseat the scanning center that keeps track of all digital slides in thesystem 10.

After the review and analysis is complete, the consultant 40 thendiscusses the case with the referral source 20, e.g., through a phonecall or a digital slide conferencing session hosted by the scanningcenter 30 that includes both audio and visual information. For example,the scanning center 30 (or consultant 40) could host a digital slideconference during which the consultant 40 would review the findings withthe referral source 20, e.g., a referring pathologist and/or patient.This conference could be recorded and stored in data storage areas 25,35 or 45 (or any combination of these) for augmenting the patient'smedical file. Additionally, a detailed or summary report can begenerated by the scanning center 30.

In one embodiment, a patient may request a second opinion from theirattending medical professional (e.g., surgeon, oncologist, internist, ordoctor). If the requested second opinion is denied (e.g., has alreadybeen performed by the lab or medical group, is medically unnecessary,would not be paid for by the insurance carrier, etc.), the patient candecide to pay directly for the second opinion. Accordingly, the doctor(referral source 20) sends the physical or digital slide to the scanningcenter 30 or consultant 40 so that the second opinion can be rendered.The digital slide conference can then take place to deliver the secondopinion to the referral source 20 (e.g., doctor and patient). Thepatient may make payment directly to the scanning center 30 who in turnmakes payment to the consulting pathologist 40. The patient may alsomake payment directly to the consultant 40 or to the attending medicalprofessional who in turn makes payment to the consultant 40.

Advantageously, for the referral source 20 that is requesting the secondopinion, the second opinion network provides easy access to a network ofleading experts that operate as consultants 40. The second opinionnetwork, through its digital slide conferences also provides a way for areferring medical professional to discuss the findings of the consultant40, thus improving the medical professional's diagnosis skills. For theconsultant 40, providing an increased volume of second opinionconsultations without billing hassles has economic benefits and may alsoincrease notoriety for the consultant 40. For patients, benefits includeincreased confidence that the patient is accessing the skills of aleading expert to ensure that the diagnosis is correct and the peace ofmind that comes from getting that opinion quickly.

FIG. 2 is a flow diagram illustrating an example process forimplementing a second opinion network according to an embodiment of theinvention. The illustrated process may be carried out by a scanningcenter such as previously described with respect to FIG. 1. Initially,in step 150 the scanning center receives the microscope slide. If theslide is a physical (glass) slide then in optional step 160 the scanningcenter digitally scans the physical slide and then returns the physicalslide to the referral source. Advantageously, using digital pathologyand centralizing the scanning function results in a significant increasein physical slides being returned to the referral source.

Once the scanning center has the digital slide, it makes the slideavailable to one or more consultants via a data network, as shown instep 170. For example, a consultant may login to the scanning center viathe Internet and review the digital slide. Certain security measures maybe taken at the scanning center to ensure privacy.

Next, in step 180 the scanning center receives an indication that theconsultation is complete. This indication may be the completion of ananalysis report or something similar. Or the indication may be an emailor other message. The indication may also be in some other form capableof being received and processed by the scanning center such as a fax,phone call, selection of a radio button or other item via a userinterface. Many alternatives for providing an indication of the analysisbeing complete are available as will be understood by those skilled inthe art.

Once the consultant has completed the second opinion analysis, thescanning center in step 190 hosts a digital slide conference between theconsultant and the referral source (e.g., patient, doctor, lab, etc.).The digital slide conference can be an audio-video conference that takesplace over a data communication network that interconnects the referralsource, the scanning center, and the consultant. The digital slideconference may be recorded and inserted into the patient's file. If thereferral source and the consultant decide not to conduct a digital slideconference, the consultant may deliver a report to the referral sourcedirectly, or indirectly via the scanning center.

FIG. 3 is a flow diagram illustrating an example process forfacilitating a second opinion analysis according to an embodiment of theinvention. The illustrated process may be carried out by a scanningcenter such as previously described with respect to FIG. 1. Initially,in step 300 the scanning center posts the digital slide on a server thatis accessible by the consultant, for example via the Internet. Next, instep 310 the scanning center sends the access information to one or moreconsultants. The access information may be in the form of a link or itmay be a simple notice that the consultant has a digital slide waitingreview.

In one embodiment, more than one consultant may be sent the accessinformation and only the first to respond is engaged for the secondopinion. Alternatively, more than one consultant may be sent the accessinformation and only the first to complete the review and analysis isengaged for the second opinion. Introducing competition in this fashionhas the desired effect of decreasing TAT for second opinions.

Next, in step 320 the scanning center determines if the turn around timehas expired for the review and analysis of the digital slide that wassent to the consultant. If the TAT has expired, then the scanning centermay take down the digital slide from the server. Alternatively, thescanning center may revoke access for the first consultant and circleback to step 310 and send an access instruction to a subsequentconsultant.

If the TAT has not expired, and the scanning center receives an accessrequest, as determined in step 340, then the request from the consultantis authorized in step 350 and the digital slide is provided to theconsultant for analysis. In one embodiment, the digital slide is onlydisplayed on a monitor at the location of the consultant and is notdownloaded to the consultant work station for offline viewing orstorage. Alternatively, the digital slide may be downloaded to theconsultant workstation for local storage and offline viewing.

FIG. 4 is a flow diagram illustrating an example process forfacilitating a digital slide conference according to an embodiment ofthe invention. The illustrated process may be carried out by a scanningcenter such as previously described with respect to FIG. 1. Initially,in step 400 the scanning center provides the digital slide to theconsultant, either by displaying the slide on a screen at the consultantworkstation or by downloading the digital slide to the consultantworkstation as previously described. Next, in step 410 the scanningcenter receives an indication that the consultation/analysis iscompleted and then in step 420 the scanning center initiates a digitalslide conference between the referral source and the consultant.Advantageously, the conference may be an audio-visual conference wherethe referral source and the consultant simultaneously view the digitalslide on their respective workstations with an audio connection to allowfor discussion while viewing the slide. In step 430 the scanning centerprovides the digital slide to each participating party so that allparties can view the slide simultaneously.

In step 440, the scanning center receives a markup from one of theparticipants in the digital slide conference. In one embodiment, theconsultant may lead the digital slide conference and therefore theconsultant may make annotations on the digital slide at the consultant'sworkstation. The scanning center receives these types of markups (e.g.,annotations) and then propagates the markups to the displays of each ofthe other participants. For example, the consultant may circle aparticular feature in the digital slide and that same circle would thenappear around the particular feature on the screen at the referralsource. The scanning center is configured to host the digital slideconference and may also include features that allow the variousparticipants to take control of the session, to make privateannotations, and the like. Additionally, the scanning center isconfigured to record the digital slide conference, which then may becomepart of the patient's medical record.

FIG. 5 is a block diagram illustrating an example computer system 550that may be used in connection with various embodiments describedherein. For example, the computer system 550 may be used in conjunctionwith the referral source, scanning center, or consultant previouslydescribed with respect to FIG. 1. However, other computer systems and/orarchitectures may be used, as will be clear to those skilled in the art.

The computer system 550 preferably includes one or more processors, suchas processor 552. Additional processors may be provided, such as anauxiliary processor to manage input/output, an auxiliary processor toperform floating point mathematical operations, a special-purposemicroprocessor having an architecture suitable for fast execution ofsignal processing algorithms (e.g., digital signal processor), a slaveprocessor subordinate to the main processing system (e.g., back-endprocessor), an additional microprocessor or controller for dual ormultiple processor systems, or a coprocessor. Such auxiliary processorsmay be discrete processors or may be integrated with the processor 552.

The processor 552 is preferably connected to a communication bus 554.The communication bus 554 may include a data channel for facilitatinginformation transfer between storage and other peripheral components ofthe computer system 550. The communication bus 554 further may provide aset of signals used for communication with the processor 552, includinga data bus, address bus, and control bus (not shown). The communicationbus 554 may comprise any standard or non-standard bus architecture suchas, for example, bus architectures compliant with industry standardarchitecture (“ISA”), extended industry standard architecture (“EISA”),Micro Channel Architecture (“MCA”), peripheral component interconnect(“PCI”) local bus, or standards promulgated by the Institute ofElectrical and Electronics Engineers (“IEEE”) including IEEE 488general-purpose interface bus (“GPIB”), IEEE 696/S-100, and the like.

Computer system 550 preferably includes a main memory 556 and may alsoinclude a secondary memory 558. The main memory 556 provides storage ofinstructions and data for programs executing on the processor 552. Themain memory 556 is typically semiconductor-based memory such as dynamicrandom access memory (“DRAM”) and/or static random access memory(“SRAM”). Other semiconductor-based memory types include, for example,synchronous dynamic random access memory (“SDRAM”), Rambus dynamicrandom access memory (“RDRAM”), ferroelectric random access memory(“FRAM”), and the like, including read only memory (“ROM”).

The secondary memory 558 may optionally include a hard disk drive 560and/or a removable storage drive 562, for example a floppy disk drive, amagnetic tape drive, a compact disc (“CD”) drive, a digital versatiledisc (“DVD”) drive, etc. The removable storage drive 562 reads fromand/or writes to a removable storage medium 564 in a well-known manner.Removable storage medium 564 may be, for example, a floppy disk,magnetic tape, CD, DVD, etc.

The removable storage medium 564 is preferably a computer readablemedium having stored thereon computer executable code (i.e., software)and/or data. The computer software or data stored on the removablestorage medium 564 is read into the computer system 550 as electricalcommunication signals 578.

In alternative embodiments, secondary memory 558 may include othersimilar means for allowing computer programs or other data orinstructions to be loaded into the computer system 550. Such means mayinclude, for example, an external storage medium 572 and an interface570. Examples of external storage medium 572 may include an externalhard disk drive or an external optical drive, or and externalmagneto-optical drive.

Other examples of secondary memory 558 may include semiconductor-basedmemory such as programmable read-only memory (“PROM”), erasableprogrammable read-only memory (“EPROM”), electrically erasable read-onlymemory (“EEPROM”), or flash memory (block oriented memory similar toEEPROM). Also included are any other removable storage units 572 andinterfaces 570, which allow software and data to be transferred from theremovable storage unit 572 to the computer system 550.

Computer system 550 may also include a communication interface 574. Thecommunication interface 574 allows software and data to be transferredbetween computer system 550 and external devices (e.g. printers),networks, or information sources. For example, computer software orexecutable code may be transferred to computer system 550 from a networkserver via communication interface 574. Examples of communicationinterface 574 include a modem, a network interface card (“NIC”), acommunications port, a PCMCIA slot and card, an infrared interface, andan IEEE 1394 fire-wire, just to name a few.

Communication interface 574 preferably implements industry promulgatedprotocol standards, such as Ethernet IEEE 802 standards, Fiber Channel,digital subscriber line (“DSL”), asynchronous digital subscriber line(“ADSL”), frame relay, asynchronous transfer mode (“ATM”), integrateddigital services network (“ISDN”), personal communications services(“PCS”), transmission control protocol/Internet protocol (“TCP/IP”),serial line Internet protocol/point to point protocol (“SLIP/PPP”), andso on, but may also implement customized or non-standard interfaceprotocols as well.

Software and data transferred via communication interface 574 aregenerally in the form of electrical communication signals 578. Thesesignals 578 are preferably provided to communication interface 574 via acommunication channel 576. Communication channel 576 carries signals 578and can be implemented using a variety of wired or wirelesscommunication means including wire or cable, fiber optics, conventionalphone line, cellular phone link, wireless data communication link, radiofrequency (RF) link, or infrared link, just to name a few.

Computer executable code (i.e., computer programs or software) is storedin the main memory 556 and/or the secondary memory 558. Computerprograms can also be received via communication interface 574 and storedin the main memory 556 and/or the secondary memory 558. Such computerprograms, when executed, enable the computer system 550 to perform thevarious functions of the present invention as previously described.

In this description, the term “computer readable medium” is used torefer to any media used to provide computer executable code (e.g.,software and computer programs) to the computer system 550. Examples ofthese media include main memory 556, secondary memory 558 (includinghard disk drive 560, removable storage medium 564, and external storagemedium 572), and any peripheral device communicatively coupled withcommunication interface 574 (including a network information server orother network device). These computer readable mediums are means forproviding executable code, programming instructions, and software to thecomputer system 550.

In an embodiment that is implemented using software, the software may bestored on a computer readable medium and loaded into computer system 550by way of removable storage drive 562, interface 570, or communicationinterface 574. In such an embodiment, the software is loaded into thecomputer system 550 in the form of electrical communication signals 578.The software, when executed by the processor 552, preferably causes theprocessor 552 to perform the inventive features and functions previouslydescribed herein.

Various embodiments may also be implemented primarily in hardware using,for example, components such as application specific integrated circuits(“ASICs”), or field programmable gate arrays (“FPGAs”). Implementationof a hardware state machine capable of performing the functionsdescribed herein will also be apparent to those skilled in the relevantart. Various embodiments may also be implemented using a combination ofboth hardware and software.

Furthermore, those of skill in the art will appreciate that the variousillustrative logical blocks, modules, circuits, and method stepsdescribed in connection with the above described figures and theembodiments disclosed herein can often be implemented as electronichardware, computer software, or combinations of both. To clearlyillustrate this interchangeability of hardware and software, variousillustrative components, blocks, modules, circuits, and steps have beendescribed above generally in terms of their functionality. Whether suchfunctionality is implemented as hardware or software depends upon theparticular application and design constraints imposed on the overallsystem. Skilled persons can implement the described functionality invarying ways for each particular application, but such implementationdecisions should not be interpreted as causing a departure from thescope of the invention. In addition, the grouping of functions within amodule, block, circuit or step is for ease of description. Specificfunctions or steps can be moved from one module, block or circuit toanother without departing from the invention.

Moreover, the various illustrative logical blocks, modules, and methodsdescribed in connection with the embodiments disclosed herein can beimplemented or performed with a general purpose processor, a digitalsignal processor (“DSP”), an ASIC, FPGA or other programmable logicdevice, discrete gate or transistor logic, discrete hardware components,or any combination thereof designed to perform the functions describedherein. A general-purpose processor can be a microprocessor, but in thealternative, the processor can be any processor, controller,microcontroller, or state machine. A processor can also be implementedas a combination of computing devices, for example, a combination of aDSP and a microprocessor, a plurality of microprocessors, one or moremicroprocessors in conjunction with a DSP core, or any other suchconfiguration.

Additionally, the steps of a method or algorithm described in connectionwith the embodiments disclosed herein can be embodied directly inhardware, in a software module executed by a processor, or in acombination of the two. A software module can reside in RAM memory,flash memory, ROM memory, EPROM memory, EEPROM memory, registers, harddisk, a removable disk, a CD-ROM, or any other form of storage mediumincluding a network storage medium. An exemplary storage medium can becoupled to the processor such the processor can read information from,and write information to, the storage medium. In the alternative, thestorage medium can be integral to the processor. The processor and thestorage medium can also reside in an ASIC.

The above description of the disclosed embodiments is provided to enableany person skilled in the art to make or use the invention. Variousmodifications to these embodiments will be readily apparent to thoseskilled in the art, and the generic principles described herein can beapplied to other embodiments without departing from the spirit or scopeof the invention. Thus, it is to be understood that the description anddrawings presented herein represent a presently preferred embodiment ofthe invention and are therefore representative of the subject matterwhich is broadly contemplated by the present invention. It is furtherunderstood that the scope of the present invention fully encompassesother embodiments that may become obvious to those skilled in the artand that the scope of the present invention is accordingly limited bynothing other than the appended claims.

1. A system for facilitating delivery of digital slide image analysisinformation, comprising: one or more referral source devices each havinga digital slide scanning means, wherein a referral source device isconfigured to scan a glass slide and create a digital slide image thatis the subject of the digital slide image analysis, the referral sourcedevice further configured to send the digital slide to a scanning centervia a data communication network; one or more scanning centers eachhaving a data storage area configured to store a plurality of digitalslides and associated information regarding the plurality of digitalslides, the one or more scanning centers each having a digital slideviewing means configured to provide image data from a digital slide toone or more remote viewers, the one or more scanning centers furtherconfigured to receive and store digital slide image analysis informationand provide said digital slide image analysis information to a referralsource device upon request; one or more consultant devicescommunicatively coupled with the scanning center and the referral sourcedevice via the communication network, wherein the consultant device isconfigured to operate as a remote viewer and receive an image of adigital slide from the scanning center and provide the image on adisplay of the consultant device for analysis, the one or moreconsultant devices configured to facilitate sending of digital slideimage analysis information to a scanning center.
 2. The system of claim1, wherein the data storage area at the scanning center comprises aplurality of digital slide records, wherein a portion of the digitalslide records include references to remotely stored digital slide imagedata.
 3. The system of claim 1, wherein the referral source devicecomprises a local data storage area and the referral source device isfurther configured to store a scanned digital slide in the local datastorage area and send profile information of the locally stored digitalslide image that is the subject of the digital slide image analysis tothe scanning center via the data communication network.
 4. The system ofclaim 3, wherein the profile information includes a reference to thedigital slide image data located in local data storage at the referralsource.
 5. The system of claim 4, wherein the scanning center isconfigured to receive a request for digital slide image data from aconsultant device and facilitate delivery of digital slide image datafrom data storage at the referral source to the consultant device. 6.The system of claim 5, wherein the referral source device is furtherconfigured to transition locally stored digital slide images to thescanning center for long term storage.
 7. The system of claim 1, whereinthe referral source is configured to access digital slide image analysisinformation stored in the data storage area at the scanning center viathe communication network.
 8. The system of claim 1 wherein the scanningcenter further comprises a digital slide conference means configured toestablish a conference between one or more referral source devices andone or more consultant devices.
 9. The system of claim 1, wherein thescanning center further comprises a timing means configured to enforcepredetermined time limits for the consultant device to access thedigital slide.
 10. The system of claim 9, wherein the timing means isfurther configured to enforce predetermined time limits for theconsultant device to provide digital slide image analysis information.11. A technical system for facilitating delivery of digital slide imageanalysis information, comprising: a referral source device having adigital slide scanning means, wherein the referral source device scans aglass slide to create a digital slide that is the subject of the digitalslide image analysis; a scanning center having a data storage areaconfigured to store a plurality of digital slides and associatedinformation regarding the plurality of digital slides, the scanningcenter having a digital slide hosting means configured to provide imagedata from a digital slide to one or more remote viewers, the scanningcenter having a digital slide conference means configured to establish aconference between one or more referral source devices and one or moreconsultant devices, wherein the scanning center receives the digitalslide that is the subject of the digital slide image analysis from thereferral source via a communication network; one or more consultantdevices communicatively coupled with the scanning center and thereferral source device via the communication network, wherein theconsultant device receives an image of said digital slide from thescanning center and provides the image on a display of the consultantdevice for analysis, the consultant device further configure to join adigital slide conference hosted by the scanning center that includes thereferral source device.
 12. A computer implemented method forfacilitating delivery of digital slide image analysis information,comprising: receiving a digital image of a microscope slide and relatedmetadata from a referral source device via a communication network;storing the digital image and the related metadata in a data storagearea; providing the digital image to a consultant device via thecommunication network to allow a consultant to analyze the digital slideand render a digital slide image analysis; receiving analysisinformation from the consultant device via the communication network;and notifying the referral source device that the analysis informationhas been received.
 13. The method of claim 12, further comprisingestablishing a digital slide conference between the referral sourcedevice and the consultant device, wherein the digital slide conferencecomprises simultaneous display of the digital slide image on thereferral source device and the consultant device.
 14. A computerimplemented method for facilitating delivery of digital slide imageanalysis information, comprising: receiving metadata related to adigital image of a microscope slide (digital slide) from a referralsource device via a communication network; storing the digital slidemetadata in a data storage area; notifying a consultant device via thecommunication network that a digital slide image is available forviewing to allow a consultant to analyze the digital slide and render adigital slide image analysis; receiving a request for the digital slideimage from the consultant device; facilitating the delivery of thedigital slide image from the referral source device to the consultantdevice via the communication network; receiving digital slide imageanalysis information from the consultant device via the communicationnetwork; and notifying the referral source device that the digital slideimage analysis information has been received.
 15. The method of claim14, further comprising receiving the digital slide image after receivingthe digital slide image analysis information and storing it in the datastorage area in association with the digital slide metadata.
 16. Themethod of claim 14, further comprising establishing a digital slideconference between the referral source device and the consultant device,wherein the digital slide conference comprises simultaneous display ofthe digital slide image on the referral source device and the consultantdevice.